IVIM对于诊断胎盘植入及不同植入区域的应用价值
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南京医科大学第一附属医院

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江苏省妇幼健康重点学科(新生儿医学),项目编号28


Application value of IVIM in diagnosing placenta accreta and different implantation regions
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The First Affiliated Hospital of Nanjing Medical University

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    摘要:

    目的:探讨体素内不相干成像(Intravoxel incoherent motion, IVIM)对于胎盘植入及植入区域的诊断价值。方法:回顾性收集在我院行MRI检查(包含IVIM序列)并在本院生产的113例单胎妊娠孕晚期孕妇,根据手术记录及病理结果分为胎盘植入组(59例)及非植入组(54例)。选取非植入组中包含S1区及S2区的15例病人,以腹膜反折为界分为非植入组S1区域及非植入组S2区域;选取植入组中在S1区及S2区均植入的病例(22例),将植入部位以腹膜反折为界分为S1植入区域及S2植入区域。计算灌注分数(f)、灌注扩散系数(D*)及标准扩散系数(D),比较各组间灌注结果的差异并分析参数的诊断价值。结果:胎盘植入组f值高于非植入组(f胎盘植入组=31.35(7.56)vs f非植入组=28.76(4.91),P =0.011,ROC曲线中f值诊断胎盘植入的曲线下面积是0.639。S2植入区域f值较S1植入区域升高(fS2植入区域=35.62±6.28 vs fS1植入区域=30.77±6.41,P=0.023)。结论:IVIM参数f值可定量评估胎盘植入时的高灌注状态,亦可用于辅助胎盘植入及植入不同部位的诊断。

    Abstract:

    Objective: To investigate the diagnostic value of intravoxel incoherence imaging (IVIM) for placenta accreta spectrum (PAS) and topography of placental invasion. Methods: Retrospectively collected 113 patients who underwent MRI examination (including IVIM sequence) and given birth in our center. Patients were divided into placental implantation group (PAS) (n=59) and non-implantation group(n=54) according to surgical records and pathological results. 15 cases of the non-implantation group who had both S1 and S2 areas were selected and divided into S1 area of non-implantation group(N-S1) and S2 area of non-implantation group (N-S2) based on peritoneal reflection; For the cases (n=22) implanted in both S1 and S2 areas, the implantation sites were divided into S1 area of PAS group (PSA-S1) and S2 area of PAS group based on peritoneal reflection. The perfusion fraction (f), perfusion diffusion coefficient (D*) and standard diffusion coefficient (D) were calculated to compare the differences in perfusion results among the groups and analyze the diagnostic value of the parameters. Results: The f value of PAS group was higher than that of non-implantation placenta group (f PAS group=31.35(7.56) vs f non-implantation placenta group=28.76(4.91), P =0.011); The f value of PAS-S2 was higher than PAS-S1 (fPAS-S2 =35.62±6.28 vs fPAS-S1 =30.77±6.41,P=0.023). Conclusion: The IVIM parameter f-value can be utilized to quantitatively evaluate the placenta accreta's hyper-perfusion condition, and f-value may be used in assisting the diagnosis of placenta accreta spectrum (PAS) and topography of placental invasion.

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  • 收稿日期:2023-03-02
  • 最后修改日期:2023-06-15
  • 录用日期:2023-08-29
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